Organization
MICHAEL D KIM MD PC
Active
Other names
FAIRFAX FAMILY MEDICINE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D KIM MD (PRESIDENT)
(703) 591-4100
Entity
Organization
Contact information
Practice address
10801 MAIN ST, SUITE 700, FAIRFAX, VA 22030-4745
(703) 591-4100
(703) 591-5380
Mailing address
10801 MAIN ST, SUITE 700, FAIRFAX, VA 22030-4745
(703) 591-4100
(703) 591-5380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101233609
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010002834
—
VA
01
—
2110066
MAMSI PPO
—
01
—
3314356
AETNA HMO
—
01
—
465828
ANTHEM BCBS
—
01
—
625622
NCPPO
—
01
—
7741476
AETNA PPO
—
01
—
H9840001
CAREFIRST
—
Enumeration date
06/20/2006
Last updated
10/26/2009
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